NEDA Week 2013: Finding Compassion

Welcome to NEDA week. Each year, this week gives us a chance pay special attention to the problem of disordered eating in our society. Here at CR, eating disorders get quite a bit of attention throughout the year, but I like the idea of a week in which a kind of collective consciousness arises around the issue.

In the past, some of you have expressed a little frustration with the focus given to EDs on the blog. I totally understand that the topic doesn’t resonate with everyone, and I also know that there are countless other urgent issues in the world that also demand attention from bloggers and readers. But disordered eating just happens to be a problem I’ve encountered intimately, and as you’ll see in this post, I’m still very much in contact with it as someone who dwells on a college campus. So I feel both compelled and responsible to write about it. If you’d rather hang back for a couple of days and return to CR later in the week, when it’ll be business as usual, that is totally cool! For the next few days, in honor of NEDA week, I’m going to give some thematic focus to Green Recovery stories and to ED awareness here on the blog.

The other day, I was drifting through the Georgetown student center when I caught sight of a girl dividing her snack bar into little pieces. She would periodically pick the wrapper up and read the nutrition panel, then return to the business of sectioning the bar, picking a fragment up, staring at it, and putting it back down. As I watched this, I caught myself thinking “Oh god. Just eat the snack bar. It’s not going to kill you.”

People who have had eating disorders often see disordered behavior everywhere and in everyone. I’m guilty of it for sure, so when I see a behavior that looks suspicious, I do my best not to automatically project. Who knows what I saw that day: maybe the girl was simply distracted and playing with her food. Or maybe she really was engaged in the waltz of food restriction, the careful apportioning of calories and fat. Either way, I hope never to have a thought so dismissive as “oh god, just eat it. It’s not going to kill you” again.

Because the truth is that, when you’re wrapped up in an eating disorder, you really do feel as though one bite of something forbidden is the end of the world. Either you believe that it will do you physical harm—by poisoning your body with sugar, carbs, or fat—or you fear, consciously or unconsciously, that it will crush your sense of identity. When I was anorexic, my sense of self was completely entangled with my restrictive patterns. I ate less than other people, “cleaner” than other people. I had no needs, no wants, no bodily desires. When I was forced to eat, either for social reasons or because I was so hungry and tired of restricting that I surrendered to a craving, the identity I’d crafted was completely dismantled. “One bite” of food didn’t just evoke fears of weight gain; it threatened the abstemiousness upon which all of my self-worth rested.

No story illustrates this better than a meal I shared with my best friend, Gabi, during my freshman year of college. We were in the student center, and I was trying to skip lunch, as I often did, by citing a sour mood. Something was amiss with the guy I was dating, and I was too sad to eat, I said. The boy drama was real, but of course the desire to abstain from food had nothing to do with him. Skipping meals had become so much a part of my habits that I was horrified of doing otherwise. Gabi insisted I get something—just a toasted bagel, she begged—and I did it to please her. Halfway through our meal, she caught me tearing up pieces of the bagel and stuffing them into my napkin. I had hoped I could get away with throwing them out later.

This incident actually brought on some laughter—nervous laughter, maybe, but laughter nonetheless. This is not because I had careless friends; indeed, all of my friends knew that something was wrong with my relationship with food, and they voiced their concerns to me frequently. I didn’t deny it, but I wouldn’t go so far as to admit I had an eating disorder, either. At the time of this incident, none of my friends, Gabi included, could have known how fine the line would be between my disordered eating habits as a freshman and the full blown relapse that would come two years later, when I was a junior.

When I look back on that day, I’m more struck by my panic and horror at the thought of eating than I am by the humor Gabi and I shared after I’d been busted. I remember how I broke into an anxious sweat when encouraged to eat. I remember feeling as though my lofty goals for the day were about to come crashing down, and with them my sense of pride. I remember being furious at Gabi; I remember thinking that, if the price of eating was going to be a feeling of weakness and failure, I’d start making up excuses not to eat with my friends at all. I remember feeling pretty certain that just one bite of that bagel was going to destroy me.

Which is why, twelve years later, I should hardly be capable of dismissing the fear and panic that another young woman might be feeling as she ponders taking a bite of food.

When you’ve passed through an eating disorder, it’s tempting to sometimes lose patience with those who haven’t yet conquered their own demons. Having realized how much better life is on the other side of recovery, you simply want to scream “Snap out of it! Choose life! You’ll be so much happier once you’re free of this!”

But that’s not how it works, is it? When I was sick, I was at least vaguely aware of the fact that “normal life”—unfettered socializing, enthusiastic meal taking, no obsession with exercise or calories—was probably better than my anxious and obsessive existence. But what if it wasn’t? What if the things I knew I’d have to give up by getting better—my sense of control, my fragile body, the perverse pride I took in my capacity to (in the words of my friend Jordan) “survive for a year on nothing but cigarettes and Swedish fish”—might actually turn out to be even more precious to me than normalcy? I was so paralyzed by the thought of life without these emotional crutches that recovery didn’t often feel like a risk worth taking. And so I persisted, year after year, in avoiding it. When I did bounce back from my college relapse, it was more for the sake of my friends and family than for myself. It wasn’t until my early twenties that I was fully prepared to embrace recovery, and everything that came with it.

From the outside, eating disorders can be very ugly indeed. Viewed in different lights, they can seem unconscionably privileged, horribly narcissistic, or painfully myopic. They are a bit of all of these things; to this day, it mortifies me to admit that I used to throw away food when I knew full well that access to food is a luxury. When we see a man or woman who is dissecting a snack bar into tiny pieces or stashing a bagel into a napkin, our instinct is often to feel infuriated with the selfishness of the act. But it’s important for us—all of us, including those of us who have had eating disorders, but may have forgotten what they’re really like—to remember that eating disorders are mental illnesses. And they are the mental illnesses with the highest mortality rate in this country. It may seem preposterous for anyone to believe that one bite of a bagel, or one slice of cake, or one French fry, is the end of the world. But when your mind and body have been altered by an eating disorder, that feeling is completely real, and totally inescapable.

A great deal of attention is given to the cultural influences that underlie disordered eating: impossibly thin Hollywood starlets, runway models with skeletal bodies, magazine ads, TV messaging that invites us to take pride in ourselves and then pummels us with weight loss ads. I believe that all of these things contribute to the prevalence of disordered eating in our society. But I think it’s important to note that eating disorders not only responses to culture. If they were, most everyone would have them, and while I sometimes make a wise crack that practically everyone in our society has an ED, I realize that this isn’t true.

In the last fifty years, our understanding of mental illnesses, including depression and bipolar disorder, has progressed enormously. Though many people still do harbor the idea that someone with clinical depression can “snap out of it,” more and more of us have come to see that one simply cannot will one’s way in and out of mental illness. Recovery and management are possible, yes, but it’s usually necessary to acknowledge that a problem exists, and seek out professional help and personal support.

I’m loathe to make breezy comparisons between eating disorders and other mental illnesses; each affliction is unique. But I do believe that eating disorders merit the same kind of attention and care given to other mental illnesses, because they are too often dismissed as pathological narcissism.

As an interesting side note, it’s worth pointing out that some cases of disordered eating maybe be correlated with certain genes. In 2003, Dr. Dorothy Grice and a team of researchers studied 192 families in which at least one person had been diagnosed with anorexia, and at least one other with what is now referred to as an EDNOS (eating disorder not as specified). There were no genetic similarities common to the entire sample of subjects, but when the team studied the thirty-seven families in which two or more relatives suffered from anorexia nervosa, they were able to identify the possibility of a likely genetic linkage common to all of the subjects. Serotonin and opioid receptor regions were found to have a significant association to anorexia, and genes for the serotonin 1D receptor (HTR1D) and the opioid delta receptor (OPRD1) were identified on chromosome 1, pairs, 36.3–34.3—a region identified by the scientists in a linkage analysis of anorexia. I’m particularly interested in the fact that serotonin, a neurotransmitter that helps to modulate pleasure, is implicated in this study; many people with eating disorders ultimately develop “highs” from being hungry, and I was definitely one of them.

The fact that scientists are discovering such correlations is no reason for despair; countless illnesses with genetic underpinnings respond to treatment, mental illnesses included. I also don’t mean to minimize the role of society/culture in ED genesis, or the role of one’s family history, inner life, and experience. But getting back to the larger point of this ambling post, which is the necessity of compassion toward those who are suffering, I think it’s important for us to keep in mind that eating disorders arise from a complex mix of culture, personal history, genetic predisposition, and numerous other factors that we have yet to fully understand. Such awareness may help those who don’t know much about EDs to recognize them as the urgent afflictions they are. Eating disorders aren’t just extreme diets. They are illnesses that demand attention and sympathy, even when they are perplexing or frustrating.

In other words, even when we want nothing more than to take someone by the shoulders and tell her that the fragment of food she’s obsessing over won’t kill her, we’d do well to remember that her fears and anxieties are very potent, and feel very real. We should remember that she is suffering. Certainly I, of all people, should remember this.

So, as NEDA week begins, I’m vowing not to forget how acute the struggles of ED life were for me once upon a time. I’m remembering that one doesn’t just choose to be so afraid of food that it feels perfectly reasonable to divide it into tiny pieces and then try to confiscate it. I’m reminding myself that the benefits of recovery weren’t always obvious to me—indeed, for thirteen whole years, they escaped me altogether. I’m hoping that one thing I write—or one comment left on this blog—will prove to just one reader that recovery is worth it.

Most of all, I hope that you all have, or are on your way to having, a true understanding of your own value.

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